Inspection on 09/05/05 for Garden Lodge

This inspection was carried out on 9th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Garden Lodge 10/07/07

Garden Lodge 27/09/06

Garden Lodge 10/10/05

Garden Lodge 01/11/04

Garden Lodge 26/04/04

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Garden Lodge 37a Lincoln Road Glinton Peterborough PE6 7JS Lead Inspector Alison Hilton Unannounced 09 May 2005 @ 08:55 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Garden Lodge I53 I03 S15117 GARDEN LODGE V224873 090505 STAGE 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Garden Lodge Address 37a Lincoln Road, Glinton, Peterborough, PE6 7JS Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01733 252980 01733 252980 Mrs Touran Watts As above Care Home 10 Category(ies) of Old age, not falling within any other category registration, with number (10) of places Garden Lodge I53 I03 S15117 GARDEN LODGE V224873 090505 STAGE 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 1st November 2004 Brief Description of the Service: Garden Lodge is a residential home in the village of Glinton close to the city of Peterborough. The home is registered for 10 older people. Garden Lodge is a chalet bungalow providing residential accommodation on the ground floor, with office accommodation on the first floor. The residential accommodation consists of eight single and one double bedroom. Two bedrooms have en-suite facilities. There is one large communal room set out with separate seating and dining area, and a smaller seating area in an annex. There is a patio outside and a very large garden.The home is close to village amenities, which include a shop, post office and public houses. Peterborough city centre is approximately six miles from the home. Garden Lodge I53 I03 S15117 GARDEN LODGE V224873 090505 STAGE 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection undertaken between 08:55 and 16:35 hrs on Monday 9th May 2005. On the day of inspection one resident was in hospital and eight were in the home. During the inspection three staff members, six residents and the registered manager were spoken to, files and documents were seen. What the service does well: What has improved since the last inspection? What they could do better: Although the gardens are extensive the patio area allowing access was uneven and staff said they went outside with residents to make sure they did not fall. There are rooms that have an unpleasant odour and it was discussed how this could be improved. Staff need to be aware of the homes policies and procedures in the event of a resident falling during the night. Garden Lodge I53 I03 S15117 GARDEN LODGE V224873 090505 STAGE 4.doc Version 1.30 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Garden Lodge I53 I03 S15117 GARDEN LODGE V224873 090505 STAGE 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Garden Lodge I53 I03 S15117 GARDEN LODGE V224873 090505 STAGE 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2,3,4,5 and 6 The manager generally gathers enough information to ensure the home can provide an appropriate placement for prospective residents. She does need to make sure forms are fully completed to prevent medical issues that could affect other residents, becoming a problem. EVIDENCE: Contracts, terms and conditions and letters agreeing the prospective residents needs could be met by the home were seen on the day of inspection ensuring that residents know what to expect from the home. Assessments had been provided by some authorities before admission, however there was one file where the information was out of date as the person was on the waiting list for the home for some months and no update had been sought to check if needs had changed. The manager only completed part of an admission form for this resident at admission and as a result key information was not asked resulting in concerns for the well being of other residents. Individual records are kept for each of the residents and three residents files were seen. They contained enough information to make sure staff could meet their needs and that these had been properly assessed and planned for. Garden Lodge I53 I03 S15117 GARDEN LODGE V224873 090505 STAGE 4.doc Version 1.30 Page 9 Garden Lodge does not offer intermediate care. Garden Lodge I53 I03 S15117 GARDEN LODGE V224873 090505 STAGE 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9, and 10 The health and personal care needs of residents are being met, providing a safe and caring environment that all residents spoken to said they were happy with. EVIDENCE: Individual plans of care were seen for each of the three residents whose files were inspected. Residents spoken to during the inspection were clear that they had been involved with their plan of care and reviews although it was not evident on the files seen. It was suggested that residents sign the review sheet completed by staff to provide the necessary evidence. Risk assessments are completed. Staff spoken to were aware of individual residents health, personal and social care needs and through their actions demonstrated that they knew how to meet them. They were seen to be polite and treat residents with respect. Daily notes made for every resident were clear and concise. They were detailed where significant events had occurred. Garden Lodge I53 I03 S15117 GARDEN LODGE V224873 090505 STAGE 4.doc Version 1.30 Page 11 Medication was stored correctly and safely in a locked cupboard. Staff have been trained to give medicines out to residents. Medication for the three residents whose files had been seen were checked and were correct. Garden Lodge I53 I03 S15117 GARDEN LODGE V224873 090505 STAGE 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14 and 15 The main meals are generally good, but residents felt and the inspector confirmed that choice was limited in relation to breakfast cereal and teatime sandwiches and extras such as crisps, fruit and yoghurt. EVIDENCE: All residents who had family and friends visit said they were made welcome. There were no restrictions on visiting times. A ‘phone is available for residents to use privately to telephone friends or family if they wish. Those residents spoken to said that they could take part in various activities in the home if they wanted to. The home arranges quizzes, armchair exercises, visiting library, board games and outside entertainers. The home also has religious services on a regular basis. Some residents were happy with the meals provided in the home and others less so. On the day of inspection a meal was taken with the residents and consisted of Shepherds pie, carrots and cauliflower followed by mincemeat tart and custard. All was well presented and nutritious. There were concerns from the residents, staff and in the opinion of the inspector that variety and options were not available. The store cupboard, freezers and fridge did not contain a Garden Lodge I53 I03 S15117 GARDEN LODGE V224873 090505 STAGE 4.doc Version 1.30 Page 13 lot of food and residents commented that there had been no ice cream for over a week and no squash. Recently when asked what they wanted for tea there had been no crisps, yoghurt or fruit. There were only two breakfast cereals (porridge and weetabix) and residents would like cornflakes as well. The manager stated that there was due to be a delivery of food the following day and she had been out to buy some fruit during the inspection. It was suggested that the way the list is prepared to order food should be reviewed. The residents have meetings with the manager every few weeks as well as the manager spending time with them all individually on an almost daily basis. It was suggested that issues around food be formalised in both the group and individual discussions to make sure that issues are dealt with and as a record that residents are or are not happy with the meals and food provided at the time. Garden Lodge I53 I03 S15117 GARDEN LODGE V224873 090505 STAGE 4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16and 18 Residents complaints had been listened to and dealt with to their satisfaction. EVIDENCE: The manager said that all residents’ families have been supplied with a new copy of the complaints procedure as recommended at the last inspection. Residents spoken to said that when they had made a complaint it had been dealt with by the manager and things had improved. All residents spoken to said they would talk to staff if they were unhappy with aspects of their care. The manager stated that staff are due to go on a course in relation to the protection of vulnerable adults from abuse. Garden Lodge I53 I03 S15117 GARDEN LODGE V224873 090505 STAGE 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,22,23,24,25 and 26 The bedrooms at Garden Lodge are tastefully decorated and these are personalised with furniture and pictures and other belongings. Access to the patio is uneven, which means residents cannot go outside independently or safely. EVIDENCE: Although the gardens are extensive and well maintained, with good access through patio doors in the dining room, the patio area allowing access was uneven and badly maintained. Staff said they went outside with residents to make sure they did not fall. Residents spoken to said they were sad that they were unable to independently access the gardens. The home had two rooms, which had unpleasant odours. The manager is trying to find cleaning products, which will remove the problem. Garden Lodge I53 I03 S15117 GARDEN LODGE V224873 090505 STAGE 4.doc Version 1.30 Page 16 Bedrooms seen during the inspection were light and airy. All had personal possessions and pictures and other items in them. The water temperature is checked and recorded in relation to Legionella. Fridge and freezer temperatures are checked usually daily. Garden Lodge I53 I03 S15117 GARDEN LODGE V224873 090505 STAGE 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29 and 30 The procedures for the recruitment of staff provide safeguards to offer protection for people living at the home. Staff were friendly and caring in their actions and worked with residents to ensure they could enjoy living at Garden Lodge. The manager needs to make sure policies and procedures are followed by her staff to ensure resident’s are protected. The manager needs to follow the disciplinary procedures in the home to ensure the safety of residents. EVIDENCE: Garden Lodge I53 I03 S15117 GARDEN LODGE V224873 090505 STAGE 4.doc Version 1.30 Page 18 The staff at the home are all female, but this does not appear to be a problem for the residents or staff in relation to the support given to male residents. There are no residents who require the assistance of two carers. The manager is aware that if there is a change in the physical or mental health needs of any resident then the staffing levels would need to be reviewed. There continues to be one member of staff on duty from 08:00 to 15:00 hrs, one from 15:00 to 22:00 hrs and one waking night from 22:00 to 08:00hrs. During the week there is also a cook/carer from 09:30 to 13:30 hrs. There is always a member of staff (who lives close by) on call and the manager is often in the home completing paperwork and providing extra care time. The manager stated that one to one care is always given if a service user is unwell. There had been an incident where a resident had been left on the floor after falling in their room from 3am to 9am when a second carer came on duty. The home has an on call system and although the manager had spoken to the staff member it was unclear why this had not been used. It is not acceptable for anyone to be left on the floor for this length of time. The home has a hoist but this was not used because of the position the person was in the room. The manager stated the issue had been raised with the member of staff and had also been discussed in a staff meeting. The manager said she had not used the homes disciplinary procedure having discussed the issue. The home has policies and procedures to address this situation but these were not followed. The manager said that she will monitor any further incidents very closely. New staff at the home had the POVA First check and CRB in place before they began work at Garden Lodge. The homes procedure for recruitment had been followed. Garden Lodge I53 I03 S15117 GARDEN LODGE V224873 090505 STAGE 4.doc Version 1.30 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,36,37 and 38 The managers style is relaxed but there are times when she needs to lead, not by example but by managing, to make sure the safety and welfare of residents is remembered by staff to be paramount. EVIDENCE: The manager is registered with the commission. She has wide experience in care and has owned Garden Lodge for some years. The manager said she is always available to residents and staff and those spoken to confirm this. The manager said that time in the home is spent completing paperwork and spending time with the residents. She has an open door policy and her management style is relaxed. Garden Lodge I53 I03 S15117 GARDEN LODGE V224873 090505 STAGE 4.doc Version 1.30 Page 20 In discussions with the manager it was evident that where possible she tries to lead by example, however this friendly style makes it difficult to discipline or ensure staff are completing set tasks adequately. The home is due to complete a quality assurance review in September 2005. Staff stated they received supervision from the manager, and that they have completed all statutory courses. Two staff are currently doing NVQ Level 2. Garden Lodge I53 I03 S15117 GARDEN LODGE V224873 090505 STAGE 4.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 2 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 2 3 3 3 3 3 3 2 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 3 3 x 3 3 3 Garden Lodge I53 I03 S15117 GARDEN LODGE V224873 090505 STAGE 4.doc Version 1.30 Page 22 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. Standard 3 15 19 Regulation 14 16 (2) (i) 23 (2) Requirement The registered person must ensure a pre-admission assessment is completed in full. The registered person must ensure that a variety of food is provided. The registered person must ensure that the premises are kept in a good state of repair externally. (This is in relation to the patio). The registered person must ensure that the home is kept free of odours. This was a requirement from the last inspection with a date for action of 30/11/04. The registered person must ensure that staff have information about the homes code of practice and ensure the homes procedures are followed. This is in relation to an incident in the home. Timescale for action 10 June 2005 26 May 2005 10 July 2005 4. 26 16 (2) (k) 10th June 2005 5. 30 18 (4) 19th May 2005 6. Garden Lodge I53 I03 S15117 GARDEN LODGE V224873 090505 STAGE 4.doc Version 1.30 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard 9 28 33 Good Practice Recommendations The registered person should provide an easier surface on the driveway for those service users with walking difficulties or in wheelchairs. The home has until 2005 to achieve a minimum ratio of 50 staff trained to NVQ 2 or equivalent. The manager is aware. The registered manager should establish a system for reviewing and improving the quality of care. This includes providing the Commission with a report in respect of the review. This is expected by September 2005. Garden Lodge I53 I03 S15117 GARDEN LODGE V224873 090505 STAGE 4.doc Version 1.30 Page 24 Commission for Social Care Inspection CPC1, Capital Park Fulbourn Cambridge CB1 5XE National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Garden Lodge I53 I03 S15117 GARDEN LODGE V224873 090505 STAGE 4.doc Version 1.30 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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